标题：不同手术方式治疗儿童四肢骨折对患者术后骨密度和骨代谢水平的影响

      作者：夏永杰，游超，邓超，周益彪，鄂兵，夏安宁    深圳市儿童医院骨科，广东 深圳 518026

      卷次： 2022年33卷14期

      【摘要】 目的 探讨不同手术方式治疗儿童四肢骨折对患儿术后骨密度和骨代谢水平的影响。方法 选择2017年9月至2021年3月深圳市儿童医院收治的98例四肢骨折患儿为研究对象，根据随机数表法将患儿分为微创组和开放组各 49例。开放组患儿给予开放复位内固定术治疗，微创组患儿给予微创内固定术治疗。术后 30 d，比较两组患儿的临床疗效、骨密度、甲状旁腺激素(PTH)、总Ⅰ型胶原氨基端延长肽(TPINP)及并发症发生情况。结果 微创组患儿的临床治疗总优良率为 95.92%，明显高于开放组的 83.67%，差异有统计学意义(P<0.05)；治疗后，微创组患儿的骨密度、PTH分别为 0.61±0.04、(1.95±0.42) pmol/L，明显低于开放组的 0.76±0.07、(4.27±1.14) pmol/L，TPINP为(519.82±52.83) ng/mL，明显高于开放组的(431.84±41.94) ng/mL，差异均有统计学意义(P<0.05)；微创组患儿的并发症发生率为4.08%，明显低于开放组的16.33%，差异有统计学意义(P<0.05)。结论 相比于开放复位内固定术，四肢骨折患儿行微创内固定术后疗效更加显著，同时可以明显改善患儿骨密度和骨代谢水平，值得推广应用。
      【关键词】 四肢骨折；儿童；微创内固定术；骨密度；骨代谢水平；临床疗效；并发症
      【中图分类号】 R726.8 【文献标识码】 A 【文章编号】 1003—6350（2022）14—1859—03

Effects of different surgical methods on postoperative bone mineral density and bone metabolism in children withlimb fractures.
XIA Yong-jie, YOU Chao, DENG Chao, ZHOU Yi-biao, E Bing, XIA An-ning. Department of Orthopedics,Shenzhen Children's Hospital, Shenzhen 518026, Guangdong, CHINA
【Abstract】 Objective To investigate the effect of different surgical methods on the postoperative bone mineraldensity and bone metabolism in children with limb fractures.Methods A total of 98 children with limb fractures admit-ted to Shenzhen Children's Hospital from September 2017 to March 2021 were selected as the research objects. Accord-ing to the random number table method, the children were divided into a minimally invasive group and an open group,with 49 children in each group. The children in the open group were treated with open reduction and internal fixation,and the children in the minimally invasive group were treated with minimally invasive internal fixation. At 30 days afteroperation, the clinical efficacy, bone mineral density (BMD), parathyroid hormone (PTH), total type Ⅰ collagen ami-no-terminal extension peptide (TPINP) and complications were compared between the two groups. Results The clini-cal efficacy rate of the minimally invasive group was 95.92%, which was significantly higher than 83.67% of the opengroup (P<0.05). After treatment, the bone mineral density and PTH of the children in the minimally invasive group were0.61±0.04, (1.95±0.42) pmol/L, which were significantly lower than 0.76±0.07, (4.27±1.1) pmol/L of the open group,and the TPINP was (519.82±52.83) ng/L, significantly higher than (431.84±41.94) ng/L in the open group (P<0.05). Thecomplication rate of the minimally invasive group was 4.08%, which was significantly lower than 16.33% of the opengroup (P<0.05). Conclusion Compared with open reduction and internal fixation, minimally invasive internal fixationin children with limb fractures has a more significant effect, and it can significantly improve the bone mineral densityand bone metabolism in children, which is worthy of application and promotion.
      【Key words】 Limb fractures; Children; Minimally invasive internal fixation; Bone mineral density; Bone metabo-lism level; Clinical efficacy; Complication　　　·短篇论著·doi:10.3969/j.issn.1003-6350.2022.14.025